Why I’ll Never Call Chemo “Poison”

It might sound obvious, but let me tell you: It sucks being diagnosed with cancer at age 26. I've put my personal and professional life on hold to undergo treatment for Hodgkin’s lymphoma. I’ve also put my body through a grueling physical regimen that I suspect would bring even the toughest Crossfitter to her knees. Chemotherapy. Just writing the word makes me shudder. Last month, another person with Hodgkin’s made the news. Cassandra C., a 17-year-old from Connecticut, was forced to undergo chemotherapy by the Connecticut Supreme Court. She had initially refused treatment because she viewed it as “poison.” I can understand why she felt that way. I've waited anxiously for my veins to "pop" up under a hot blanket, so the nurse could insert the IV. I've watched the bright-red Adriamycin as it was pushed slowly into my body (if it goes in too quickly, it can cause severe tissue damage). I’ve suffered through my fair share of tedious E.R. visits for things as minor as a low-grade fever and as serious as a pulmonary embolism. Needless to say, it’s been a brutal six months of treatment. In order to put a somewhat humorous spin on my situation, I’ve often joked that I was heading to the infusion room to "get poisoned." Then, Cassandra was quoted in the media using the same word — poison. While this is a rather dramatic way to describe the basic chemistry behind chemotherapy, it is not entirely factually incorrect. In order to kill cancer cells, chemotherapy drugs also destroy healthy cells. Translation: These indiscriminate medications wreck havoc on your body, causing many unpleasant side effects throughout the process. Let’s talk about some of these side effects. The most notable one is hair loss. That’s fun! There’s also nausea. And, don't forget the weakened immune system, insomnia, blood clots, or weight gain. (Yes — contrary to the image of the waifish cancer patient that pervades popular culture, many patients going through chemotherapy actually gain weight). I would continue, but unfortunately, one other common side effect — chemo brain — is preventing me from remembering all the fun little surprises one encounters on this long road.

If it wasn't already clear, I haven't enjoyed any of this. And, like most cancer patients, I’ve struggled with the idea that the very thing that was making me feel so awful was also the cure. Still, in a strange way, I’ve learned to appreciate chemotherapy; it’s definitely not an ideal way to treat cancer, but it's the most effective treatment we have. Cassandra’s situation has prompted me to rethink the language I use to describe it. Her story is very complicated, both legally and morally. In general, adults should have the choice to pursue or refuse treatment as they see fit — even if their decisions go against the norm. And, while it makes me extremely uncomfortable, I even believe that physician-assisted suicide should be legal on a federal level in the case of a painful terminal illness (this belief was reinforced after the Brittany Maynard saga last year). But, Cassandra's case is different. For one thing, she is still a child. While I like to think I was a pretty sharp 17-year-old, I wouldn’t trust my not-yet-fully-developed teen brain to make a life-and-death decision. Second, the odds of a full recovery for Cassandra are (pardon The Hunger Games reference), ever in her favor. Thanks to breakthroughs in radiation and chemotherapy, Hodgkin’s has become one of the most treatable cancers. With standard treatment, the five-year survival rate for patients is about 90%. Most patients live much longer than five years and are, in fact, cured after the first-line treatment. Without treatment, Hodgkin’s is fatal. While no one wants to receive a cancer diagnosis or go through such a torturous treatment plan, I can’t imagine how much harder it must have been to receive such devastating news as a teenager. Even at 26 — almost a full decade older than Cassandra — I’m no stranger to hearing the sympathetic murmur: “Oh, this is so unfair! You’re so young!” I agree: It’s not fair. But, at least I was able to live a (relatively) carefree life as a young adult before the Big C reared its ugly head. Unfortunately, Cassandra had to grow up a lot faster and face some dark moments that no one — let alone a child — should have to endure. But, it will be worth it. After a grueling six-month journey, Cassandra will most likely come out of this cancer-free and ready to take on the world. All because of chemotherapy.

A few decades from now, there is a good chance we will look back at chemotherapy as completely barbaric. After all, it means you have to get sicker in order to get better. But, while there are many promising studies demonstrating the efficacy of immunotherapy and other non-chemotherapy approaches to treatment, these studies are still in infancy, and it will likely be at least a few years before doctors have an equally effective alternative to treating cancer. So, with chemotherapy as the most effective current method of treatment (and one that is directly responsible for saving thousands of lives each year) I have now declared a moratorium on calling it "poison" — even when I’m kidding around. Instead, I've embraced what chemotherapy really is: a crucial, life-saving medicine that I am thankful to be receiving, even if I totally hate it as it’s flowing through my veins. I have just one more infusion left to go before I’m (hopefully) done with this long ride. While I am not in the clear yet, I am already ready to say a premature "thank you" to the chemo drugs for doing their job and killing my cancer — and the cancer of thousands of patients like me and Cassandra. Adriamycin, Bleomycin, Vinblastine, and Dacarbazine, I salute you. Even if you did make me lose my hair.